CompetitiveAccess Training Guide

Transcription

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2 CONTENTS Introduction Introduction to Competitive Access...3 Using Competitive Access Using Competitive Access...4 Accessibility Specification...5 Census File...6 Network Selection...8 Interpreting Results Network Ranking...9 Gap Map...10 Gap Map Detail...11 Provider Detail...14 Gap Details, Top Hospitals, Top Markets...15 Exporting Results Export Instructions

3 INTRODUCTION Competitive Access (CompAccess) is a feature of Strenuus Network360 TM platform that allows you to perform an accessibility analysis by comparing a member census file to a provider network in conjunction with a set of accessibility standards. Competitive Access differs from other accessibility software that you may be familiar with in the following ways: Results are available in seconds or minutes, rather than hours. Results are available for your selected network, selected competitor networks in your project, and the Total Market simultaneously. To learn more about Strenuus methodology for determining Total Market see the Appendix. The analysis includes a Gap Map which graphically displays out-of-network provider candidates who could help you improve your network s accessibility results. The tool can produce results quickly because many of the calculations required for this analysis are performed in advance, when the project is run. If a project previously has not been designated for Competitive Access, or if changes are made to the project or specialty mappings, additional processing may be required before Competitive Access can be used for that project. Contact your Network360 Administrator if you have questions. 3

4 USING COMPETITIVE ACCESS To open Competitive Access, click on the Measure Access tile on the left hand side of the Network360 dashboard. This will bring you to the setup screen, which will look similar to this: The three sections on the setup page are Accessibility Specification, Census File Upload, and Network Selection. 4

5 USING COMPETITIVE ACCESS Accessibility Specification An accessibility specification is a collection of accessibility standards based on requiring a minimum number of providers within a certain distance. Two Distance Types are offered: Straight-Line Distance (As The Crow Flies) and Estimated Driving Distance. Minimum count and mileage standards for a given provider type or specialty can vary depending on the population density of the area where members are located. Two population density classifications are offered: USR (Urban-Suburban-Rural), and CBSA (Large Metro, Metro, Micro, Rural, CEAC). To create a new Specification: Click next to Accessibility Specifications and type a name for the specification. Select an Access Standard Type (USR/CBSA classification) and a Distance Type, then click Save. To select an existing Specification: Click the down arrow next to the Select an accessibility specfication text (or currently selected Specficiation name) and select from the drop-down. To change the name of the current Specification or to change the Distnace Type, click the pencil icon:. To delete an exisiting Specification, click the trash bin icon:. Editing Accessibility Standards Each Specification contains a list of standards composed of provider types or specialties and a set of count and mileage requirements for each population density class. There is no limit to the number of standards you can create for each specification, but remember that access is calculated based on whether each member location meets all standards simultaneously. To delete a standard, click the trash icon next to the unwanted standard. To edit the count and mileage requirements in a standard, click the pencil icon next to the standard. The maximum provider count requirement is 6. If you set the count to zero, the requirement is effectively ignored for that classification. The maximum mileage requirement is 140 for rural and CEAC classifications. Mileages are offered in pre-defined increments. Click Save when finished. To change the provider type or specialty in a standard, first delete the unwanted standard by clicking the trash icon, and then create a new standard by clicking the Add Standard button. Select the appropriate provider type or specialty and re-enter the count and mileage requirements. Specifications are dependent on the specialty mapping in use when they are created. They can be applied to other projects and utilized by other Network360 users in your organization as long as the project has the same specialty mapping as the project where the Specification was originally defined. 5

6 USING COMPETITIVE ACCESS Census File Selecting or Uploading a Census File In addition to the access standards to be applied, Competitive Access needs to have a member census file for the analysis ( Member is a generic term applied to any census file in this context.). You may select an existing census file (if any) from a drop-down list by clicking the current file name, or you can upload a new census file by clicking next to the current file name. Census files uploaded by other users in the project are available for selection. It must be a CSV or Microsoft Excel 2003 or higher file. It must contain one column labeled zip which contains the zip codes in the census file. It may contain another column labeled member_count which contains the number of Members in each zip code. It may contain other columns which will be ignored. However, to ensure a successful upload, it s a good idea to remove extraneous columns first. For convenience, if the zip column contains multiple instances of the same zip code, the system will total them up for you, whether or not the file contains a member_count column. To upload a file, click the Choose File button. Navigate to the census file you want to upload and select it. 6

7 USING COMPETITIVE ACCESS Building a Census File If you do not have a census file or want to analyze a general area instead of specific member population, Network360 Competitive Access module allows you to build a census file using the latest U.S. Census/ACS data. To build a census file, click on the down arrow next to the plus sign in the Census File Upload section, then choose Build Census File. Name the census file by typing the title in the Name field. Select whether you want to build census based on General population or just the Medicare Eligible population. Next, in the Location field, select the geography you want to use for your analysis. You may enter cities, counties, MSAs, CMS Rating Areas, state abbreviations, or zip codes. The system will convert the geographies you have selected into a comma-delimited text file that contains zip codes to be used in the analysis. At this time, census file cannot be downloaded from the system. Upon successful uploading, you will receive a confirmation message. In some cases, you may also see a message indicating that some zip codes fall outside the geography of the project. These zip codes and the Members in them will be ignored in the analysis. Contact your Network360 Administrator if you have questions. 7

8 USING COMPETITIVE ACCESS Network Selection All that is left is to select the networks you want to include in the analysis. In the Gap Map portion of the results, only the Base Network is considered. The base network is normally one of your networks. You may select as many Comparison Networks as you want. Accessibility will be calculated for them as well, but they will not be evaluated in the Gap Map. Note that if more than six networks are selected in total, the Hospital Report will not be available in the PDF export, though it will still be viewable on screen. Running the Analysis To run the report, click the Perform Analysis button. Note that while all of the distance calculations have been completed in advance, it may still take some time for the results to display. The amount of time will range from a couple of seconds to as long as ten minutes for very large projects, which may include tens of millions of records that need to be queried. Very large census files will also lengthen the processing time. Once each report tab is rendered, however, the results are stored in your browser s cache and can be reviewed later almost instantly. 8

9 INTERPRETING RESULTS When the results of the analysis first appear, you will see a Network Ranking screen similar to the one below. The top portion of the screen will show the selected Accessibility Specification, Census File, Base Network, and Comparison Networks. There is also a link to take you back to the setup screen, and an Export button, which will be discussed later. There are five tabs in the result set for Competitive Access: Network Ranking, Gap Map, Gap Details, Top Markets, and Top Hospitals. Network Ranking The first tab is the Network Ranking tab. This tab graphically depicts the percentage of all Members having access for each of the networks selected, as well as the Total Market. They are ranked in order from highest to lowest, with the Base Network in bold. One of the things that differentiates Competitive Access from other accessibility tools is the inclusion of the Total Market. This useful metric shows the maximum access percentage attainable by any network, since it includes ALL known providers. Frequently, this access percentage is somewhat less than 100%, and could be used to justify gaps in accessibility when they are due to provider demographic considerations rather than network composition. Hovering your mouse over the bars will reveal the member counts associated with the 9

10 INTERPRETING RESULTS Gap Map The Gap Map is a visual depiction of the geographic areas where network access is less than the Total Market access percentage. In other words, it shows the counties (or zip codes) where access could be improved by recruiting additional known providers. This powerful feature allows you to instantly see where your network development focus should be with respect to the given specification and census file. It is available only for the selected Base Network. Gap Map Detail The Gap Map Detail, which can be seen by clicking on the county (or zip code) in question, provides additional information, including the details you need to begin to actually improve your accessibility results. In the figure above, you can see that the county in red, Marshal County, is one area where accessibility is lower than Total Market and could be improved. Hovering your mouse over the county (or zip code) reveals the details of the accessibility percentage for that geographic subdivision in the upper right corner of the map. Note that only counties or zip codes where access can be improved are clickable on this map. Counties or zip codes where access is already 100%, or already equal to the Total Market access percentage, are not clickable, since there is nothing that can be done to improve access in those counties or zip codes. 10

11 INTERPRETING RESULTS Gap Map Detail Here are the components of the Gap Map Detail header and their purpose: Region Type is the population density classification of the county (or zip code) being viewed. Members in County (or Zip Code) is the number of Members within the county (or zip code) from the selected Census File. Member Access is the percentage of the Members in this county (or zip code) that have access based on the Access Specifications and the Base Network. Best Possible Access is the percentage of the Members in this county (or zip code) that could have access based on the Access Specifications and the Total Market (all known providers). Just below the header, you will see details relating to the map shown. The map is based only on individual failed standards those where less than 100% of Members have access. Failed Access Standard is the individual standard within the Access Specification for which the highest attainable access percentage was not achieved. If there is more than one failed standard, clicking this field will reveal a drop-down list of the others. Access Standard is the count and mileage requirement for that failed access standard. Member Access and Best Possible Access are the access percentages for that standard and the Base Network and Total Market, respectively. Note that the access percentage for the failed standard may not agree with the access percentage for the county or zip code being viewed if there are multiple failed standards. Remember that access for the county or zip code is based on the entire set of standards contained in the Access Specification. The access percentage for the county or zip code is thus the consolidated access percentage of each individual standard. The Gap Map Detail shows only one failed standard at a time. 11

12 INTERPRETING RESULTS Gap Map Detail Features Looking at the map portion of the Gap Map Detail, you ll notice overlapping shaded circles and map markers denoting provider locations. The overlapping shaded circles are centered on member locations for which the access standard in question is not met. The radius of each circle coincides with the mileage requirement. Thus, only providers located within the circle could potentially improve access for that member location. Providers outside of the overlapping circles are shown for reference only. The provider markers come in a variety of shapes and colors: Green markers indicate high confidence provider locations, yellow indicates medium confidence, and red indicates low confidence. For more information about address confidence, contact your Network360 Administrator. Markers with checkmarks in them are in-network providers. In-network refers to the selected Base Network. Markers without checkmarks are out-of-network providers. When located within the red overlapping circles, they constitute the providers with whom the access percentage could be increased if they were part of the network. They are your target providers. Clusters represent locations with many providers. Click to zoom in on clusters. Gray markers are hospitals. Hovering your mouse over the markers pops up additional informaiton about the provider. 12

13 INTERPRETING RESULTS Gap Map Recruiting List To see a list of providers that will help you meet your defined accessibility standard, you can create a Recruiting List from the Gap Map Detail. From the Gap Map Detail, select the failed standard for which you would like a Recruiting List. Then, click Recruiting List in the tab header. You will be taken to a list of providers within the mileage requirement and not in your base network. This list can be saved and exported, just like other provider lists throughout the application. Specialty and Address Confidence Filtering and Adjustment To narrow the list to only those providers with high address or specialty confidence, or to expand it to those providers with lower address or specialty confidence: 1. Click the filter icon to the right of Recruiting List button 2. Adjust the confidence sliders. 3. Click Recruiting List. The resulting list will contain providers meeting the address and specialty confidence scores you have selected. Note: By default, recruiting list is based on confidence scores of 70% or greater but the best possible access standard is based on all providers. 13

14 INTERPRETING RESULTS Viewing Provider Details From the Gap Map Detail, there are two ways to see additional details about particular providers. As noted above, hovering your mouse over the provider marker pops up additional information. Clicking on the provider marker, however, opens up a split screen view of the Gap Map Detail. The right side of the split screen shows many of the same details about the provider that are found in the Provider Profile, but without leaving the Gap Map Detail screen. From the split screen view, there are many actions that you can take: To view the Provider Profile, click on the provider s name. To tag the provider, click the next to Tags. Tagging the provider will allow you to produce a list of tagged providers later using Create a List. To highlight the provider by changing the marker to a star, click Highlight Provider. This is useful if you are reviewing several providers and want to bookmark a particular provider location. To hide providers you have considered but rejected, click Hide Provider. Hidden providers can be revealed by clicking Show all hidden providers in the bottom right corner of the map. Note that hiding providers from this view will also hide them from other organizational users who run Competitive Access with this project. 14

15 INTERPRETING RESULTS Gap Details Gap Details shows tabular information about the results of the analysis at the zip code level. It includes any zip code and access standard for any of the selected networks and the Total Market where member access was less than 100%. Gap Details can be most useful when exported. Exporting is covered later. Top Markets The Top Markets report shows accessibility for up to the 15 largest markets (based on the geographic Report Grouping selected in Advanced Options), the base plan results and the market (best possible) results for each of the geographies. Currently, if Custom Regions are available, the Report Grouping defaults to Custom Regions. This report is included in the Competitive Access PDF export. Top Hospitals The Hospital Report shows the top ten largest hospitals (by bed count) in each market (MSA or Custom Region, sorted by member count), the member count for that market, and network tags for the hospitals. It is helpful when focusing on hospital access. 15

16 EXPORTING RESULTS Although many of the features of Competitive Access are interactive and thus most useful while navigating the application, the Export feature allows you to download most of the available content of the analysis. Export to PDF will export the Network Ranking, Gap Map, and Top Hospitals views to a PDF file that can be downloaded and shared with others. Note that the Top Hospitals view will be omitted if more than six total networks are selected for the analysis, because of the particular layout of that view. Export Gap Details to CSV will create a CSV file of the Gap Details tabular data that can be imported into Excel. Export Full Details to CSV will create a CSV file similar to Gap Details but also includes all member census zip codes and corresponding results. To export results, click the Export button to reveal a list of format choices. 16

17 College Blvd, Suite 650 Overland Park, KS As always, we welcome your feedback and ideas for improvement. If you have questions, feel free to contact your Network360 Administrator. 17